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In Support of Collaborative Practice

Jun 01, 2010
Henri R. Manasse, Jr., Ph.D., Sc.D.

Henri R. Manasse, Jr., Ph.D., Sc.D.

IN THIS ERA OF HEALTH CARE REFORM, advanced pharmacy practice, and enhanced public focus on medication safety and efficacy, you might think that health care professionals would be on the same page in our approaches to team-based, quality patient care. Unfortunately, in the case of the American Medical Association (AMA), you would be wrong.

The AMA recently released its “Scope of Practice [SOP] Data Series: Pharmacists.” This members-only document seeks to define, describe, and prescribe the scope of pharmacy practice. And it does so using erroneous information, false statements, and pure errors of fact about pharmacists’ education, training, and scopes of practice.

It is a troubling look into the way that the AMA perceives today’s pharmacist—a point of view that is clearly out of the mainstream of contemporary practice. The SOP is devoid of what prominent national boards and regulatory bodies such as the Institute of Medicine, the National Quality Forum, the American Board of Internal Medicine, and many others are saying about the importance of collaborative care.

It is clear from the document that the AMA is concerned about the way that medication therapy management (MTM) and collaborative practice agreements are evolving. Pharmacists in hospitals and health systems and nurse practitioners are moving into areas of practice traditionally handled by physicians. But it is an evolution created by need. Drug misadventures are a reality.

With more than 18,000 FDA-approved chemical entities and dosage forms on the market and a practice model that allows any physician to prescribe any medication at any time, there has never been a more urgent need for medication experts. Pharmacists who practice in hospitals and health systems are those experts.

The current state of practice, including a greater demand for pharmacists’ clinical skills and a growing number of new practitioners seeking pharmacy residencies, further bears out the need for pharmacists’ medication management services in the context of team-based care.

Instead, even though collaborative drug therapy management is currently authorized in 45 states, the AMA has chosen to use their policy document to raise fears in the reader that pharmacists aren’t competent to conduct MTM.

ASHP will not passively stand by and allow this publication to go unanswered. I recently sent a letter to AMA Executive Vice President and Chief Executive Officer Michael D. Maves, M.D., M.B.A., in which I laid out the inaccuracies and untrue representations in the SOP and asked the AMA to retract the document or, at minimum, correct it.

In this new world of patient care, it will take every health profession working together to ensure that patients receive the safest, most effective care. Pharmacists are a critical component of that care delivery model, and ASHP continually stands at the ready to promote the importance of collaborative practice.

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